Differential diagnosis method for diagnosing sexual development delay in girls of prepubertal and adolescent age

FIELD: medicine.

SUBSTANCE: method involves distinguishing four degrees in sexual development delay. Minimum sexual development delay degree is characterized by the following parameters. Uterus width and thickness corresponds to age-specific norm. Median uterine M-echo is recorded. Uterus neck is differentiated from uterus body with angle between them being well distinguished. All ovarian dimensions correspond to norm. Light sexual development delay degree is characterized as follows. All uterine dimensions are two years smaller, when compared to age-specific norm. Median uterine M-echo is recorded. Uterus neck is differentiated from the uterus body. Ovary length and thickness correspond to age-specific norm. Moderate sexual development delay degree is characterized as follows. All uterine dimensions are three-four years smaller, when compared to age-specific norm. Median uterine M-echo and reduced ovary length and thickness are recorded. Severe sexual development delay degree is characterized as follows. All uterine dimensions are six-eight years smaller, when compared to age-specific norm. No uterus neck is differentiation from the uterus body is available. No median uterine M-echo is recorded. Ratio coefficient of length and anteroposterior dimension of uterine body to length and anteroposterior dimension of uterus neck is additionally determined in each sexual development delay degree case. Uterine blood vessel lumen, ovary echostructure as number, diameter of minimum and maximum follicles in them are determined in energetic Doppler mapping mode. Uterus length having 1-2 years delay when compared to norm, ratio coefficient of uterus and neck dimensions being equal to 1.5-1.7, uterine blood vessel lumen being equal to 5-6 mm, follicle number being in norm, diameter of minimum and maximum follicles having 1-2 years delay when compared to age-specific norm, minimum sexual development delay degree is diagnosed (IA). Uterine blood vessel lumen being equal to 4-5 mm, coefficient of uterus and neck dimensions being equal to 1.3-1.5, follicle number being in norm, ovary width having 1-2 years delay when compared to norm, minimum follicles having 2 years delay when compared to age-specific norm, maximum follicles having 2-3 years delay, light sexual development delay degree is diagnosed (IB). All uterine dimensions being three-four years smaller, when compared to age-specific norm, uterus neck being differentiated from uterus body with angle between them being poorly distinguished, uterine blood vessel lumen being equal to 2-3 mm, ratio coefficient of uterus and neck dimensions being equal to 1.2-1.5, reduced follicle number having 1-2 years delay when compared to age-specific norm, ovary width having 2-3 years delay when compared to norm, minimum follicles diameter having 2 years delay when compared to age-specific norm, maximum follicles diameter having 2-3 years delay, moderate sexual development delay degree is diagnosed (II). Uterine blood vessel lumen diameter being equal to 1 mm, ovaries dimensions delay being of 2-3 years with lacking follicular apparatus in them, severe sexual development delay degree is diagnosed (III).

EFFECT: high accuracy and self-descriptiveness of the method.

 

The invention relates to the field of medicine and more specifically relates to ultrasonic diagnostic delay of sexual development in prepubertal girls and adolescents with diabetes mellitus type I (DM).

Closest to the proposed method for the diagnosis of delayed sexual development (DSD) in girls and adolescents with tidm is the method (1), consisting in conducting the ultrasound examination and the determination of the parameters of the uterus and ovaries, assessment of vascularization of the uterine arteries and decreasing the length, thickness, width of the uterus, the presence or absence of median uterine M-echo, differentiation of the cervix from the uterus and the presence of weakly pronounced angle between them or the lack of it, reducing the volume of the ovaries, the number and diameter of follicles in them, reducing vascularization diagnosed with delayed sexual development.

However, application of this method is limited, because not developed precise values for the assessment of genitalia in patients prepubertal and adolescent suffering from diabetes type I, also, there is no ratio between length and anteroposterior size of the body of the uterus to the length and anteroposterior size of the cervix, the values of the evaluation criteria of the blood supply of the internal genitalia according to the energy Doppler mapping, as well as uso is archerstown classification of degrees WIA.

The new technical problem to be solved by the invention, is to improve the accuracy and informative way.

The set task is solved by a new method of differential diagnosis of delayed sexual development (PR) in prepubertal girls and adolescents with diabetes mellitus type I, consisting in the allocation of 4 degrees of delay of sexual development, namely: the minimum degree of WIA, including the following parameters: width and height of uterus correspond to the age, record of the median uterine M-the echo, the cervix differentiate from the body of the uterus, the angle between them is well expressed, all sizes ovaries are normal; mild RRP: reduction of the uterus at 2 years compared with age norms, register the median uterine M-the echo, the cervix differentiate from the body of the uterus, length, thickness ovarian corresponds to the norm; the average degree RRP: reduction of all parameters of the uterus 3-4 years compared with age norms, the cervix differentiate from the body, registering a median uterine M-an echo, a decrease of the length, the thickness of the ovaries, severe RRP: reduction of all parameters of the uterus for 6-8 years compared with age norms, the lack of differentiation of the cervix separately from the body of the uterus, absence of median uterine M-echo, and, optionally, DL is each degree WIA determine the ratio of the length and anteroposterior body size to the length and anteroposterior size of the cervix, in the mode, power Doppler mapping determine the diameter of the lumen of the uterine vessels, echoes of the ovaries: the number, the diameter of the minimum and maximum follicles in them and when the lag length of the uterus from age norms for 1-2 years, the coefficient of the ratio of the size of the uterus to the neck size of 1.5-1.7, the diameter of the lumen of the uterine vessels 5-6 mm, number of follicles, the corresponding norm, reducing the diameter of the minimum and maximum follicles 1-2 years compared with age norms diagnose the minimum degree WIA (IA); when the diameter of the lumen of the uterine vessels 4-5 mm, the ratio of the size of the uterus to the neck size is 1.3 to 1.6, the number of follicles, corresponding to the normal width of the ovaries, behind age norms for 1-2 years, reducing the minimum diameter of follicles compared with age norms for 2 years, and the maximum diameter is 2-3 years diagnosed with mild WIA (1B); the reduction of all parameters of the uterus 3-4 years compared with age norms, the presence of the differentiation of cervical cancer from the body and weakly pronounced angle between them, the diameter of the lumen of the vessels of 2-3 mm, the ratio of the size of the uterus to the size of the neck -1,2-1,5, reducing the number of follicles 1-2 years compared with age norms, the gap width of the ovaries to age for 2-3 th is compared with age norms, reducing the minimum diameter of follicles compared with age norms for 2 years, and the maximum diameter is 2-3 years diagnosed medium RRP (II), when the diameter of the lumen of the uterine vessels 1 mm, the gap parameters ovaries to age for 2-3 years and the absence of a follicular unit in them diagnosed with severe RRP (III).

These distinctive characteristics are not found in the medical-scientific and patent literature. Thus, the proposed method meets the criteria of the invention of "novelty" and "inventive step".

The described method has successfully passed clinical trials in the clinic of the Siberian medical University and meets the criterion of "industrially applicable".

The method is as follows: the patient is carried ultrasound internal genital define the position and size of the body and cervix, estimating coefficients of correlation length and anteroposterior size of the body of the uterus to the length and anteroposterior size of the cervix and the severity of the angle between them, the presence of the median uterine M-echo, determine the position, size and echostructure of the ovaries (number, diameter, minimum and maximum follicles in them) and the obtained values are compared with age norms by known methods (2, 3) Vframes (1997) the V.I. Kulakov, Kuznetsova M.N., Martysh NS (1994). Then in the mode, power Doppler mapping determine the diameter of the lumen of the uterine vessels and evaluate the vascularization of the uterus.

Thus, based on the reduction and imbalances of the body, the cervix and the ratio of their coefficients, the presence or absence of the median uterine M-echo, reduce the number and diameter of follicles in the ovaries, the differences in diameter of the lumen of the uterine vessels are classified in four degrees of delay in sexual development: the minimum degree WIA (IA), mild WIA (1B), the average degree WIA (II) and severe RRP (III) according to the characteristics of the proposed method.

The proposed diagnosis criteria were selected on the basis of data interpretation of clinical observations.

The minimum degree WIA (IA) diagnosed in 18 patients aged 11 to 18 years. Among the patients of this group of 16 people, with an average severity of DM and registered menarche. Only two girls have severe tidm and lack of menstrual function.

In patients with minimal WIA (IA) set the lag length of the uterus from age norms for 1-2 years when the line width and thickness. Defined diameter of the lumen of the uterine vessels 5-6 mm and evaluated vascularization of the uterus as high. Registered median the fallopian M-echo, differentiated cervix from the body and the presence of a pronounced angle between them. The odds ratio of the size of the body of the uterus to the neck size of 1.5-1.7. All parameters of the ovaries and the number of follicles in them corresponded to the norm, and the diameter of the minimum and maximum follicles was lagging 1-2 years compared to age norms.

Specific examples of the complete method.

Example 1. Patient K., age 12, was investigated 28.04.99. Diagnosis directions: Diabetes mellitus type I medium gravity.

Carried ultrasound internal genital organs on the unit SDU-500 SHIMADZU - transabdominal probe 3.5 MHz according to the standard technique with prior bowel preparation and filled bladder and a Doppler apparatus LOC 400 convex probe of 7.7 MHz.

On the echograms define the uterus size in length and 2.7 cm (average: 2.9 cm); width - 3.0 cm (normal: 3.0 cm); thickness - 2.5 cm (normal: 2.5 cm). The median uterine M-echo - 4 mm, which corresponds to the age. The angle between the body of the uterus and the cervix is well expressed. The ratio of the size of the body of the uterus to the size of the cervix=1,7 (norm: 2) the Right ovary: a 2.5×2,2×1.8 cm (norm: 2,5×2,2×1.8 cm) in 4 of the follicle (the norm), the minimum diameter is 3 mm (standard 6 mm) maximum 5 mm (10 mm). Left ovary: 2,7×2,2×1.9 cm (normal is 2.5×2,2×1.9 cm) in nem follicles (normal), the minimum diameter of 4 mm (6 mm), maximum 5 mm (10 mm). Mode power color Doppler mapping determine the diameter of the lumen of the uterine vessels 5-6 mm and evaluate the vascularization of the uterus as high. Conclusion: the Minimum degree WIA (IA).

Mild WIA (IB) is detected in 23 girls and adolescents aged 8 to 16 years. This group consists of 21 patient with an average severity of DM and 2 patients have severe disease. In this group 6 (22%) of teenagers have registered menarche and irregular menstrual cycle. In patients with mild WIA (IB) defined the reduction of the uterus at 2 years compared with age norms, registered the median uterine M-echo, cervix differentiated separately from the body of the uterus and defined the smaller angle between them, defined by the diameter of the lumen of the uterine vessels 4-5 mm and evaluated vascularization of the uterus as high. The odds ratio of the size of the body of the uterus to the neck size is equal to 1.3 to 1.6. Length, thickness of the ovaries and the number of follicles in them corresponded to the norm, width lagged behind age norms for 1-2 years. The minimum diameter of the follicles is reduced compared with the age norm for 2 years, and the maximum diameter is 2-3 years.

Example 2. Patient S., aged 14, were examined 23.03.2000. Diagnosis n the Board - Diabetes mellitus type I medium gravity. Delay in physical development.

Carried ultrasound internal genital organs on the unit SDU-500 SHIMADZU - transabdominal probe 3.5 MHz according to the standard technique with prior bowel preparation and filled bladder and a Doppler apparatus LOC 400 convex probe of 7.7 MHz.

On the echograms define the uterus size: length 3.9 cm (average: 4.2 cm); width - 3,7 cm (average: 3.8 cm); height - 2.7 cm (normal: 3.5 cm). The median uterine M-echo - 3 mm, and it does not fit the age. The angle between the body of the uterus and the cervix is poorly defined. The ratio of the size of the body of the uterus to the size of the cervix - 1,5 (standard: 2). The right ovary: length : 2.7 cm (average: 2.7 cm); height - 2.1 cm (average: 2.1 cm), width 2.6 cm (average: 2.8 cm); 10 follicles (norm), the minimum diameter of 4 mm (normal 6-8 mm), the maximum is 7 mm (14 mm). Left ovary: length : 2.7 cm (average: 2.7 cm); height - 1.9 cm (average: 1.9 cm), width 2.3 cm (normal: 2.5 cm); 7 follicles (norm), the minimum diameter of 4 mm (7 mm), maximum 5 mm (12 mm). In the mode, power Doppler mapping determine the diameter of the uterine vessels 4-5 mm and evaluate the vascularization of the uterus as high. Conclusion: Mild WIA (IB).

Medium RRP (II) establish the 20 surveyed in against the ones from 8 to 16 years. Diabetes moderate severity have 14 patients and 6 people suffer from severe diseases. Menstrual function in this group is not registered.

Ultrasound this group identified the reduction of all parameters of the uterus 3-4 years compared with age norms, the presence of the median uterine M-echo, cervix differentiated separately from the body of the uterus and poorly defined angle between them, defined by the diameter of the lumen of the uterine vessels 2-3 mm and evaluated the vascularization of the uterus as the average. The decrease of the coefficients of the ratio of the size of the body of the uterus to neck size: 1.2 to 1.5. The decrease of the length, the thickness of the ovaries and the number of follicles in 1-2 years, the gap width to age for 2-3 years, reducing the minimum diameter of follicles compared with age norms for 2 years, and the maximum diameter is 2-3 years.

Example 3. Patient C., age 16, were examined 15. 02 01. Diagnosis directions - diabetes mellitus type I, severe disease. Delayed physical and sexual development.

Carried ultrasound internal genital organs on the unit SDU-500 SHIMADZU - transabdominal probe 3.5 MHz according to the standard technique with prior bowel preparation and filled bladder and a Doppler apparatus LOC 400 convex probe of 7.7 MHz.

On the echograms define the uterus size: length - 3.5 cm (norm: 4,5); depth - 2.0 cm (normal: 3.0 cm); width - 3,0 (normal: 4.2 cm). The median uterine M-echo - 2 mm, which does not correspond to the age, the cervix separately from the body differentiate. The right ovary: length 2.1 cm (normal: 3.0 cm); height - 1.6 cm (average: 1.9 cm); width - 1.8 cm (normal: 2.0 cm) in it 5 follicles (norm: 6): the minimum diameter of 3 mm (standard: 6 mm), maximum 6 mm (norm: 17 mm). Left ovary: length : 2.3 cm (normal: 3.0 cm); height - 1.2 cm (average: 1.9 cm); width - 1.7 cm (average: 2.3 cm)6 follicles: the minimum diameter of 3 mm (normal: 3 mm), maximum 6 mm (norm: 17 mm). In the mode, power Doppler mapping determine the diameter of the lumen of the uterine vessels 2-3 mm and evaluate the vascularization of the uterus as the average. Conclusion: Medium RRP (II).

Severe RRP (III) determine the 21 patients aged 9 to 17 years. This group consists of 10 patients with severe diabetes and 11 people with an average degree of severity of the disease. Among patients in this group not menstruating.

When ultrasound examination of the pelvic organs established the reduction of all parameters of the uterus for 6-8 years compared with age norms, the cervix is not differentiated separately from the body, defined by the diameter of the lumen of the uterine vessels 1 mm and evaluated vascularization of the uterus as low, reginae fallopian M-the echo is not visualized, all parameters of the ovaries behind from the age of 2-3 years, follicular unit not defined. Paid attention to more significant negative impact of disease severity on the development of cancer than ovarian. Noted the negative impact of the severity of diabetes on follicular apparatus, in which the group has not set.

Example 4. Patient P., age 12, was examined 27.09.01. Diagnosis directions - diabetes mellitus type I, heavy degree. Delayed physical and sexual development.

Carried ultrasound internal genital organs on the unit SDU-500 SHIMADZU - transabdominal probe 3.5 MHz according to the standard technique with prior bowel preparation and filled bladder and a Doppler apparatus LOC 400 convex probe of 7.7 MHz.

On the echograms find the uterus size: length : 2.1 cm (average: 2.8 cm); height - 1.2 cm (normal: 2.0 cm); width - 1.5 cm (normal: 2.5 cm), median uterine M-echo and the cervix does not render. The right ovary: length 2.1 cm (normal: 2.5 cm); height - 1.6 cm (average: 1.8 cm); width - 1.8 cm (normal: 2.2 cm) and the left ovary length and 2.3 cm (normal: 2.5 cm); height - 1.2 cm (average: 1.8 cm); width - 1.7 cm (normal: 2.2 cm). Follicles in the ovaries do not define. In the mode, power Doppler mapping determine the diameter of the uterine vessels 1 mm and evaluate the vascularization of the uterus ka is low. Conclusion: Severe RRP (III).

Thus, the proposed method of differential diagnosis of delayed puberty in prepubertal girls and adolescents with diabetes mellitus type I allows the absence of invasiveness with high precision and highly informative to diagnose, delayed sexual development in prepubertal girls and adolescents with diabetes mellitus type I and assign the most appropriate condition appropriate preventive and therapeutic measures in the most optimum time.

Literature

1. Kondratiev NM (prototype) and other Ultrasonography in the diagnosis of delayed sexual development in girls and adolescents with diabetes mellitus type I. Bulletin of Siberian medicine, 2002, No. 4, p.87-92.

2. Carolina SCI Gynecological endocrinology children and adolescents. Moscow. Medical news Agency. 2001. 286 C.

3. Kulakov V.I., Kuznetsov M.N., Martysh NS Ultrasound in gynecology of childhood and adolescence. Moscow, "Medicine" 1994. 112 C.

The method of differential diagnosis of delayed sexual development (DSD) in prepubertal girls and adolescents with diabetes mellitus type I, consisting in the allocation of 4 degrees of delay of sexual development, namely: the minimum degree of WIA, including the maintenance the following parameters: width and height of uterus correspond to the age, register the median uterine M-the echo, the cervix differentiate from the body of the uterus, the angle between them is well expressed, all sizes ovaries are normal; mild RRP: reduction of the uterus at 2 years compared with age norms, register the median uterine M-the echo, the cervix differentiate from the body of the uterus, length, thickness ovaries are normal; medium RRP: reduction of all parameters of the uterus 3-4 years compared with age norms, the cervix differentiate from the body, registering a median uterine M-an echo, a decrease of the length, the thickness of the ovaries; severe RRP: reduction of all parameters of the uterus for 6-8 years compared with age norms, the lack of differentiation of the cervix separately from the body of the uterus, absence of median uterine M-echo, characterized in that it further for each degree WIA determine the ratio of the length and anteroposterior size of the body of the uterus to the length and anteroposterior size of the cervix, and in the mode, power Doppler mapping determine the diameter of the lumen of the uterine vessels, echoes of the ovaries: the number, the diameter of the minimum and maximum follicles in them and when the lag length of the uterus from age norms for 1-2 years, the ratio of the size of the uterus to the neck size is 1.5 to 1.7, the diameter of the lumen of the fallopian with the courts 5-6 mm, the number of follicles, the corresponding norm, reducing the diameter of the minimum and maximum follicles 1-2 years compared with age norms diagnose the minimum degree WIA(IA); when the diameter of the lumen of the uterine vessels 4-5 mm, the ratio of the size of the uterus to the size of the neck - 1,3-1,6, number of follicles, corresponding to the normal width of the ovaries, behind age norms for 1-2 years, reducing the minimum diameter of follicles compared with age norms for 2 years, and the maximum diameter is 2-3 years diagnosed with mild WIA (IB); the reduction of all parameters of the uterus 3-4 years compared with age norms, the presence of the differentiation of cervical cancer from the body and weakly pronounced angle between them, the diameter of the lumen of the vessels of 2-3 mm, the ratio of the size of the uterus to the neck size is 1.2 to 1.5, the reduction in the number of follicles 1-2 years compared with age norms, the gap width of the ovaries to age for 2-3 years compared with age norms, reducing the minimum diameter of follicles compared with age norms for 2 years, and the maximum diameter is 2-3 years diagnosed medium RRP (II); when the diameter of the lumen of the uterine vessels 1 mm the lag parameters ovaries to age for 2-3 years and the absence of a follicular unit in their diagnosis is irout severe RRP (III).



 

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1 dwg, 3 ex

FIELD: medicine, neurology.

SUBSTANCE: the method deals with detecting an interferon status followed by medicinal therapy. Moreover, additionally one should determine patient's body area, and at observed degree I of interferon system suppression it is necessary to prescribe "Antilympholin Kz" preparation as medicinal therapy intravenously by drops at course dosage being (0.5-0.6)g x S, where S - patient's body area, every other day, and thioctacide preparation at the dosage of 300-600 mg intravenously by drops daily at a 6-8-d-long course. In case of degrees II and III of interferon system suppression one should prescribe "Antilympholin Kz" at course dosage being 0.4-0.5 g/sq. m and 0.3 -.4 g/sq. m, as for thioctacide - it should be applied at the dosage of 600-900 mg and 900-1200 mg, correspondingly. The method enables to selectively affect the immune system efficiently due to combined prescription of an immunimodulator and a preparation that accelerates its introduction at suppressing the activity of proinflammatory cytokines that prolongs disease remission due to preventing the development of immunological disorders.

EFFECT: higher efficiency of therapy.

3 ex

FIELD: medicine.

SUBSTANCE: method involves taking foot imprint and outline picture, drawing bimalleolar line and determining longitudinal axis of the foot. To do it, transverse axis of internal ankle-bone is additionally drawn intersecting the longitudinal foot axis at right angle and the bimalleolar line at an angle of α corresponding to the magnitude of external ankle-bone displacement relative to internal ankle-bone of the tibia in its distal portion. Talocrural articulation center projection position is determined in intersecting the transverse internal ankle-bone axis at an angle of β corresponding to the magnitude of external ankle-bone displacement relative to the talocrural articulation center projection position. The external ankle-bone displacement relative to internal ankle-bone being equal to 10-15° and that of the talocrural articulation center projection to 20-30°, tibia position is considered to be normal in the distal portion of tibia. The external ankle-bone displacement relative to internal ankle-bone being equal to 15.5-20° and that of the talocrural articulation center projection to 31-40°, moderate displacement of tibia position in the distal portion of tibia is considered to be the case. The external ankle-bone displacement relative to internal ankle-bone being greater than 20,5° and that of the talocrural articulation center projection greater than 41°, marked displacement of tibia position in the distal portion of tibia is considered to be the case.

EFFECT: high accuracy of the method.

3 dwg

FIELD: medicine.

SUBSTANCE: method involves producing foot imprints on specially fixed flat-bed scanner capable to withstand human body weight load. Foot imprint processing is carried out by means of software for automating examination process. Operator marks foot image according to a pattern. The operator selects 12 key points with mouse unit and draws straight lines from point to point and calculates positions of calculatable points on foot image. Diagnostic values are calculated after having marked up the foot separately for anterior, median and posterior portions of the foot.

EFFECT: high diagnostic accuracy and accelerated examination.

4 dwg

FIELD: medicine, cardiology, endocrinology, gynecology.

SUBSTANCE: one should detect informational-valuable signs of patient's state, such as either the presence or absence of hypertonic disease and uterine extirpation together with adnexa, the value of body weight index, predominance of disorders according to modified menopausal index (MMI)such as autonomic, metabolic-endocrine or psycho-emotional ones, the type of metabolic structures of blood serum, moreover, it is necessary to echocardiographically detect stroke volume, cardiac index and systemic vascular resistance (SVR), at ultrasound testing one should detect maximal linear rate of circulation (LRC max) by medial cerebral artery and thyroid alterations, rheovasographically one should detect specific circulation (SC) of shins, at testing laser doppler flowmetry one should detect microcirculation index, biochemically it is necessary to detect the value of beta-adrenoreactivity, cholesterol level and that of B-lipoproteides, crystallographically - the presence of serotonin and dopamine crystals, due to immunoenzymatic assay on should detect the values by Table 1 and then after obtaining the values of diagnostic coefficients of every parameter it is necessary to summarize them and obtain diagnostic index (DI), at its value being below 10 one should state no alteration, at its value 10-10 - undetermined state, at its value being 21-30 - the 2nd severity degree of disorders, and at DI value being above 31 one should state the 3d severity degree of disorders available.

EFFECT: higher accuracy of evaluation.

5 ex, 2 tbl

The invention relates to medicine and can be used in endoscopic surgery

The invention relates to the field of medicine, Orthopaedics and can be used for differentiated assessment of postural disorders

The invention relates to medicine, in particular to surgery

FIELD: medicine, cardiology, endocrinology, gynecology.

SUBSTANCE: one should detect informational-valuable signs of patient's state, such as either the presence or absence of hypertonic disease and uterine extirpation together with adnexa, the value of body weight index, predominance of disorders according to modified menopausal index (MMI)such as autonomic, metabolic-endocrine or psycho-emotional ones, the type of metabolic structures of blood serum, moreover, it is necessary to echocardiographically detect stroke volume, cardiac index and systemic vascular resistance (SVR), at ultrasound testing one should detect maximal linear rate of circulation (LRC max) by medial cerebral artery and thyroid alterations, rheovasographically one should detect specific circulation (SC) of shins, at testing laser doppler flowmetry one should detect microcirculation index, biochemically it is necessary to detect the value of beta-adrenoreactivity, cholesterol level and that of B-lipoproteides, crystallographically - the presence of serotonin and dopamine crystals, due to immunoenzymatic assay on should detect the values by Table 1 and then after obtaining the values of diagnostic coefficients of every parameter it is necessary to summarize them and obtain diagnostic index (DI), at its value being below 10 one should state no alteration, at its value 10-10 - undetermined state, at its value being 21-30 - the 2nd severity degree of disorders, and at DI value being above 31 one should state the 3d severity degree of disorders available.

EFFECT: higher accuracy of evaluation.

5 ex, 2 tbl

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